final expense booklet - pipac

FINAL ARRANGEMENTS

A Pre-Planning Guide

AGENCY NAME HERE

Instructions

Dear Loved One,

Realizing that death is inevitable, I have filled out this prearrange-ment booklet with my desires and other information that will help in arranging my memorial service.

In this booklet, you’ll find information that will be required by the Funeral Director. I’ve also included details about other documents and important papers of which I want you to be aware.

When the need arises, give this folder to any Funeral Director to help in completing the final arrangements.

I sincerely hope these arrangements will be agreeable to you and will spare you needless concern, knowing that my memorial ser-vice was as I wished it.

Date ____________

FAMILY HISTORY

First name Middle Last

Street address City State Zip

Birthplace: City State Birthplace: Month/Day/Year

Citizenship

Resided in county State Lived here since

Marital status Spouse name (include maiden name)

Marriage: Date Place

Father’s name and birthplace

Mother’s maiden name and birthplace

Child’s name Birthplace




Occupation Employing company

Type of business/industry Since (year)

Social security number

Veteran/branch of service Serial no.

Name of war or dates served

Organization Rank

Enlisted at Date

Discharged at Date

Locationofdischargecertificate

PEOPLE TO NOTIFY

Immediate family member to contact/relationship

Address City State Zip

Telephone (including area code) Email

Immediate family member to contact/relationship


Telephone (including area code) Email

Name Telephone Email



Preference for immediate contact:

Funeral arrangements counselor Telephone Email


Attorney Telephone Email


Accountant Telephone Email


Family Doctor Telephone Email


Friends who will assist the family:

YouwillfindmyLastWillandTestamentat:

Youwillfindmybirthcertificatein:

My attorney is:

Location of safety deposit boxes and bankbooks for:

Life insurance Company Policy Number

Hospital and medical insurance Company Policy Number

Automobile insurance Company Policy Number

Disability insurance Company Policy Number

Others (unions or lodges):

I have bank deposits at the following banks:

I have appointed the following to be executor(trix) of my estate:

DOCUMENTS

PERSONAL MEMORIAL INSTRUCTIONS

Place of funeral or memorial service Telephone

Religiousaffiliation Placeofworship City State

Please Contact: O Minister O Priest O Rabbi O Other



Participating organizations (military, fraternal, other)

Type of service: Embalmed: O open casket O closed casketCasketcovering: Oflag-fold/placeatheadofcasket/drapecasket

Casket:metal/wood/fiberglass Interiorcolor Exteriorcolor

Outside vault or container

Cremation: O Ashes present at service

Urn or container for ashes

Clothing:

Use from current wardrobe: O yes O no

Type of clothing

Type of jewelry

O stays on O return jewelry to:

Weddingring: Ostayson Oreturnringto:

PERSONAL MEMORIAL INSTRUCTIONS

Music and Spoken Word:Omusician(s): Opre-recordedmusic

Musical selections

Favorite passage from the Bible or other literature

Cemetery decisions:

Locationofownershipcertificate/deedforcemeteryproperty

Name of cemetery


Graveside service: O yes O no

Interment:Prefer: O mausoleum entombment O lawn O crypt O collumbarium O niche

Spaces

Actual description of cemetery property to be used

Crypt or space Tier or lot Mausoleum or lawn

Vault Flower container

Memorial Bronze/granite/other

Inscription Emblem

INSTRUCTIONS

Flowers Color and type preferred

Donations(insteadofflowers)to:

Special instructions:

These are my instructions and memorial wishes.

Signed Date

Witness Date

Funeral director and professional services:

I’d like my policy be used to provide the following funeral services and merchandise:

Funeral director designation

O clothing O casket O cremation urn or container O outside vault or container

Additional professional services:

Professional services General assistance

First call from place of death Preparation of necessary papersEmbalming and proper care of body Obtaining burial permitDressing Notifying newspapersCosmetology and hairdressing Furnishing acknowledgment cardsRestorative work when necessary Preparing social security formsUse of mortuary & facilities Preparing insurance formsFuneral coach Preparing veterans formsLimousine for family use Arranging for grave spaceCar for pallbearers Arranging for opening and closing graveVisitation roomHandlingoffloralofferings

OBITUARY

Information for memorial services, newspaper articles and online use:

Name

Born at

Date

Education

Married date

Place

Religiousaffiliation

Clubs or lodges

Military record

Information about employment

Other information

Surviving relatives (list names and relationships)

YOUR FUNERAL DIRECTOR

How the Funeral Director can help:

You’ll need to contact a Funeral Director at the time of death. This is an expert licensed by the State Board. They’ll have the training and knowledge needed to carry out the service defined in this guide.

You can speak with the Director to set the time and place of the service.They can also help with tasks such as:

• Choosing a casket and clothing• Making arrangements for musicians• Contacting places of worship• Arranging newspaper notices• Getting certified copies of the death certificate

You can talk to your Director if you need your loved one moved to another place for burial. They’ll set up a shipment by funeral coach, rail or air. And, you’ll get guidance on the best and most cost-effec-tive means of transport.

They will complete all legal work for the death certificate and Burial Permit. They can also advise you about Veterans Burial Allowance and Social Security Death Benefits.

This guide is furnished by:

Agent’s name: __________________________________________________

Address: _______________________________________________________

_______________________________________________________________

Phone number: _________________________________________________

Email: _________________________________________________________

CHECKLIST

1. Notify: � The doctor or coroner

� The funeral director

� The cemetery or memorial park

� The clergy and place of worship

� All relatives

� All friends

� Musician(s) for service

� Pallbearers

� Insurance agents/companies

� Unions and fraternal organizations

� Newspapers

2. Select: (see Instructions on pages 6-8)

� Embalm

� Cremate

� Memorial estate and plot, if not already done

� Casket

� Vault or outer case

� Clothing

� Blanket or robe

� Flowers

� Music

� Food

� Furniture

� Time and place

� Transportation

� Thank you cards

3. Additional obligationsinclude:

� Providing vital statistics about de-ceased to the newspaper and person planning the service

� Preparing and signing necessary papers

� Providing addresses for all interested people who must be notified

� Answering phone calls, messages and letters

� Greeting friends and relatives who call

� Providing lodging for out-of-town guests

� Cleaning the home

� Planning funeral car list

4. Arrange payment for: � Doctor

� Nurse

� Hospital

� Medicine

� Funeral

� Cemetery plot

� Interment service

� Clergy

� Musicians

� Florist

� Clothing

� Transportation

� Telephone

� Food

� Memorials

final expense booklet - pipac

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